Mak, A.A.MakProf. TANG So Kum, CatherineCatherineProf. TANG So KumHo, Roger Chun-manRoger Chun-manHo2021-01-092021-01-092013Lupus, 2013, vol. 22(3), pp. 254-261.0961-20331477-0962http://hdl.handle.net/20.500.11861/6117Objectives<br> While patients with systemic lupus erythematosus (SLE) have poorer health-related quality of life (HRQoL) and are more depressed than healthy people, the impact of proinflammatory cytokines, particularly tumour necrosis factor-alpha (TNFα), on these unfavourable psychosocial parameters is unclear. We aim to explore potential relationships between lupus-related proinflammatory cytokines, HRQoL and depressive symptoms in patients with SLE.<br> Methods<br> Patients with SLE and age-matched healthy subjects were assessed for HRQoL and depressive and anxiety symptoms by the Short Form Health Survey-36 (SF-36) and Hospital Anxiety and Depression Scale (HADS) respectively. Using multiplex immunoassay, a panel of serum proinflammatory cytokines including TNFα, interleukin (IL)-1β, IL-6, IL-17, IL-23 and IL-33 were determined and compared between both groups. Independent associations between SF-36, serum proinflammatory cytokine levels and HADS scores were studied by regression models.<br> Results<br> In total, 54 patients and 54 healthy controls were studied. Lupus patients had significantly poorer HRQoL (p < 0.001) and were significantly more depressed (p = 0.006) and anxious (p = 0.022) than their healthy counterparts. Amongst the proinflammatory cytokines studied, serum TNFα was significantly higher in lupus patients (p < 0.001). After multivariate adjustment, higher serum TNFα (β = −0.224, p = 0.047) remained significantly associated with lower SF-36, along with smoking (β = −0.253, p = 0.014) and more severe depressive symptoms (β = −0.433, p = 0.002). In healthy subjects, serum TNFα was associated with depressive symptoms but not with SF-36.<br> Conclusions<br> Higher serum TNFα level is independently associated with poorer HRQoL and more severe depressive symptoms in SLE patients. These associations suggest a potential impact of inflammatory response on depressive symptoms and the quality of life in patients with SLE.enProinflammatory CytokinesTumour Necrosis Factor AlphaSystemic Lupus ErythematosusDepressionHealth-Related Quality of LifePeer Reviewed Journal Article10.1177/0961203312471872